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Nerve wrapping for recurrent compression neuropathy: A systematic review.
Arjuna Thakker1, Sanjeev Chaand Sharma2, Niha Mariam Hussain3
1University Hospitals Of Leicester NHS Trust, Leicester LE1 5WW, United Kingdom.
Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|December 3, 2020
Summary
Nerve wraps can improve outcomes for revision nerve compression surgery. Autologous veins, collagen, and amniotic membrane all showed benefits, though pain remains a common symptom.
Area of Science:
- Nerve regeneration and reconstructive surgery
- Biomaterials in medical applications
Background:
- Recurrent symptoms after primary nerve compression surgery affect up to 25% of patients.
- Nerve wrapping is a viable option for revision surgery to prevent fibrosis and scarring.
- An ideal nerve barrier promotes nerve gliding and minimizes scar tissue formation.
Purpose of the Study:
- To systematically review the efficacy of nerve wraps in revision nerve compression surgery.
- To evaluate autologous, allograft, and xenograft nerve wrapping options.
- To assess outcomes and complications associated with different nerve wrap materials.
Main Methods:
- Systematic review of PubMed, Ovid Embase, and Cochrane databases.
- Inclusion of 11 studies (case series) following PRISMA guidelines.
- Risk of bias assessed using the Methodological Index for Non-Randomised Studies (MINORS).
Main Results:
- 114 patients (ages 28-90) included, with prior revision surgeries ranging from 0-5.
- Autologous veins (6 studies), collagen (3 studies), and amniotic membrane (2 studies) were evaluated.
- All wrap types demonstrated improvements in subjective and objective outcomes; pain was the most common residual symptom (46%).
Conclusions:
- This is the first systematic review on nerve wraps for revision compression neuropathy.
- All evaluated nerve wrap types showed positive outcomes.
- Further comparative studies are necessary to identify the optimal nerve wrap for revision surgery.
